Gluten In Common Medications

If you have celiac disease or non-celiac gluten sensitivity, the last thing you want to do is worry about whether there is gluten in your prescription medicine. Unfortunately, this is a hard thing to decipher, as gluten does not have to be listed as an ingredient on prescription or over-the-counter medications. Since treatment for celiac disease includes complete avoidance of all gluten products that may be ingested or come in contact with the mouth, things like lip-balm and medicines with uncertain gluten content should be avoided. Ingestion of amounts as small as 25-50mg of gluten may elicit an adverse reaction (that’s the size of a crumb!). Consuming small amounts of gluten daily, as little as 50mg, can cause renewed villous atrophy after 90 days, according to a 2007 study (1). This study chose participants who had been gluten free long enough to have intestines that were well healed. Some research shows that even less gluten daily, as little as 10mg/per one kilogram of food (or 10 parts per million), may cause a response in very sensitive people. (2)

Most drugs are made up of one or two active ingredients with seven to eight fillers, absorbents, protectants, binders, coloring agents and other inactive ingredients called excipients. The pill needs filler for bulk and shape, and some of these inactive ingredients help with the absorption of the drug. The fillers are where you will probably find the gluten. The FDA does not require the manufacturer to test individual ingredients of the final product for gluten. There is also no definition for what gluten-free is in the pharmaceutical world. According to the Celiac Disease Foundation website, few medications contain gluten – but when you are trying to avoid it, every medication should be checked. It is also important to remember that the generic form of a medication is not required to use the same inactive and filler ingredients and should be checked separately.

This list of inactive ingredients that should be avoided is listed below (unless the source is specified). Any of these can be sourced from wheat, barley or rye. They most likely will be from corn, rice, tapioca or potato, but further investigation is usually needed. If wheat starch is listed, it is a product you will definitely want to avoid.

• Caramel coloring
• Dextrates
• Dextrimaltose
• Dextrin
• Modified Starch
• Maltodextrin
• Pregelenatized modified starch
• Pregelenatized starch
• Wheat

Calling the manufacturer is an option to inquire about gluten. Many companies are very open with information, while others are harder to deal with. There are two websites that can be helpful in your investigation. One is called Pillbox and the other is called Dailymed. Both can help you determine whether a medication contains gluten. The website www.glutenfreedrugs.com is maintained by a clinical pharmacist and contains a list of gluten-free medications, but it is not guaranteed to be 100 percent accurate. In September 2015, the Gluten in Medicine Disclosure Act was filed with Congress (here) to require the labeling of gluten in medications, but it currently sits with the Subcommittee on Health Action.

If you think you may be getting small amounts of gluten in your diet that are hard to avoid and you are having symptoms, you may want to try GlutenEase™. Preparations containing DPP-IV, like GlutenEase™, are often recommended to safeguard against any hidden sources of gluten. Like Digest Gold™ and other digestive enzyme preparations from Enzymedica, GlutenEase™ uses Thera-blend technology. This exclusive process combines multiple strains of enzymes that work in various pH levels. Thera-blend enzymes have been shown to be three times stronger and work more than six times faster than other leading digestive supplements.